Provider Demographics
NPI:1902054778
Name:JEFFREY F. DONIS, D.P.M., P.C.
Entity Type:Organization
Organization Name:JEFFREY F. DONIS, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-725-2010
Mailing Address - Street 1:180 E HARTSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3544
Mailing Address - Country:US
Mailing Address - Phone:914-725-2010
Mailing Address - Fax:
Practice Address - Street 1:180 E HARTSDALE AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3544
Practice Address - Country:US
Practice Address - Phone:914-725-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002361-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00416500Medicaid
NY00416500Medicaid